• George Chen, Masooma Kazmi, Danling Chen, and Jedan Phillips.
• Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8434, USA. george.chen@stonybrookmedicine.edu.
• J Community Health. 2020 Dec 1; 45 (6): 1236-1241.

AbstractSeasonal influenza continues to impose a substantial healthcare and economic burden in the United States each year. This study assessed influenza vaccination rates among the uninsured population, determined the need for free flu vaccines, and analyzed associations of vaccination status with access, beliefs, and sociodemographic factors. Stony Brook Outreach and Medical Education (SB HOME) free clinic offers free flu vaccinations to uninsured patients over the age of 18 living in Suffolk County, New York. All patients visiting SB HOME between October 2018 and February 2019 were offered a 10-min anonymous survey assessing demographic characteristics, self-evaluation of health status, vaccination status during the 2017-2018 and 2018-2019 flu seasons, willingness to obtain a free flu vaccine, and beliefs and barriers surrounding flu vaccines. Analysis consisted of descriptive statistics, paired t tests, and χ2 tests using a significance threshold of p < 0.05. A total of 102 participants were surveyed, 80% of whom identified as Hispanic/Latino. The majority of participants expressed positive attitudes towards the influenza vaccine. Despite these positive attitudes, 72% reported not receiving the influenza vaccination during the 2017-2018 flu season, the commonly cited reasons being fear of getting sick from the flu vaccine, high cost, and not knowing where to get the vaccine. During the 2018-2019 flu season 60% of participants elected to receive a free flu shot at SB HOME, and participants with positive attitudes towards flu vaccines were more likely to accept the vaccine when offered at no cost. Fear of getting sick from the flu vaccine remained the most common reason for participants declining a free flu vaccine. Only 17% of participants would seek vaccination at the market price of $30, compared to the 76% who would if the vaccine was offered for free. Our study highlights the need for convenient and affordable access to the flu vaccine among uninsured populations, who despite recognizing the benefits of receiving the flu vaccine are unable to overcome certain barriers. Elucidating and targeting barriers specific to uninsured populations at the local community level may improve public health strategies centered on increasing vaccination rates.

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